The Delivery of Kidney Care in Rural or Sparsely Populated Settings

Social determinants of health and limited access to medical care contribute to underdiagnosis and late presentation of chronic kidney disease (CKD). Rural areas face unique challenges in providing optimal care for patients with CKD due to poverty, limited health care access, and geographical barriers. This review addresses the challenges of caring for rural patients with CKD and discuss potential strategies to increase health care equity. Furthermore, we examine rural disparities in patients with CKD, patients with kidney failure on in-center or home dialysis, and patients with kidney transplants, highlighting the need for targeted interventions to address these disparities. Addressing the challenges faced by rural patients with CKD requires a multifaceted approach, including improving access to health care services, implementing telemedicine and telemonitoring technologies, enhancing the knowledge of primary care physicians around CKD, improving care coordination, and increasing preventive measures. We must create a kidney health model combining early detection, prevention, and disease surveillance to decrease disease progression. Health care policies should also incentivize and support the expansion of the rural health care workforce. Targeted interventions aimed at reducing rural disparities for patients with CKD and those using in-center hemodialysis, home dialysis, or transplantation are crucial to ensure equitable care.